Journal
MEDICAL CLINICS OF NORTH AMERICA
Volume 103, Issue 4, Pages 613-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.mcna.2019.02.007
Keywords
Premenstrual syndrome; Premenstrual dysphoric disorder; Etiology; Antidepressant; Oral contraceptive; Treatment
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Premenstrual dysphoric disorder (PMDD) comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual symptoms. Women with PMDD have a differential response to normal hormonal fluctuations. This susceptibility may involve the serotonin system, altered sensitivity of the GABAA receptor to the neurosteroid allopregnanalone, and altered brain circuitry involving emotional and cognitive functions. Serotonin reuptake inhibitors are considered the first-line treatment. Second-line treatments include oral contraceptives containing drospirenone, other ovulation suppression methods, calcium, chasteberry, and cognitive-behavioral therapy.
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